Perhaps it may be well to take this opportunity of saying a few words in regard to homoeopathic remedies and homoeopathy generally.

The mere fact that a drug in small doses will cure a disease exhibiting symptoms similar to those produced by a large dose of the drug does not constitute it a homoeopathic medicine, for this rule was known to Hippocrates, and the rule similia simi-libus curantur was recognised by him as true in some instances. But Hippocrates was not a homoeopath, and he recognised the fact that, while this rule was sometimes true, it was not invariably so.

It seems to me that, in founding the system of homoeopathy, Hahnemann has proceeded with his facts as he did with his medicines - diluting his active drugs with inert matter, and diluting his facts with much nonsense.

In what I am about to say, I may be to some extent open to correction, for I cannot claim to know his doctrines so thoroughly as those who believe in and follow him. So far, however, as I know his doctrines, it seems to me that they consist in raising the rule similia similibus curantur to the rank of a regular law; in claiming a curative power for infinitesimal doses, and in believing that the diminution in the dose of the drug was made up for by the potency conferred upon it through prolonged trituration. It is no doubt true that in some instances the power of a drug may be increased by trituration, inasmuch as fine subdivision either makes it more easily absorbed or alters its chemical composition, as in the case of mercurial compounds, where the prolonged exposure to the air and friction involved in the trituration may greatly increase the power of the drug by oxidising it, and changing it from a mercurous to a mercuric salt. But in both cases the increased activity conferred upon the drug is strictly limited, although it may be great in the case of the salts of mercury. To suppose it to be exerted ad infinitum is sheer nonsense, and the absurdity of infinitesimal doses has been so often demonstrated that it is useless to say more about it.

I think one is justified in describing Hahnemann's experiment with cinchona bark as the foundation-stone of his doctrine of homoeopathy; for Dr. Nankivell, in his Presidential Address to the British Homoeopathic Congress at Norwich, says, with regard to the action of quinine in ague, that 'it was this very instance of successful empirical treatment, of specific medicinal action, that led Hahnemann first to investigate the actions of drugs on the healthy human frame, and thus to lay the foundation of the most complete and lucid system of scientific therapeutics that the world has yet seen.' But I have shown in the body of this work (p. 52) that, although Hahnemann's observations were in all probability perfectly correct, the conclusions he drew from them were utterly erroneous.

But there is another side to the question which I think it is only fair to consider also. While Hahnemann's theory was certainly bad, there can, I think, be little doubt that he, like Paracelsus and Priessnitz, has done good service to medical practice. Paracelsus gathered information from shepherds, wise women, and quacks of all sorts, and thereby obtained a knowledge of popular remedies, not generally employed by the profession, but which were nevertheless useful.

Priessnitz did not invent the use of cold water as a remedy, for it was known nearly eighteen hundred years before his time. Musa saved the life of Augustus by the cold bath, but, not knowing exactly how and when to employ it, he killed the nephew of the Emperor by it, and such failures brought the treatment by water into discredit. Priessnitz revived it, and now in the use of cold sponging, wet packs, baths and douches we have a powerful means of treating fever and curing disease.

Hahnemann also did good, and the system which he founded has done great service by teaching us the curative power of unaided Nature, the use of diet and regimen in treating disease, and the more than inutility, the actual hurtfulness, of powerful drugs in many instances. The physician is bound to do the very utmost he can for his patient, and his very anxiety has frequently led him to do harm. He has been afraid to leave the cure of disease to Nature, and by the administration of powerful drugs has frequently injured instead of benefited his patient. The use of infinitesimal doses which could not affect the body of the patient one way or the other, but kept the mind of both patient and physician easy, and allowed the vis medicatrix natura free scope, has helped us to a more perfect knowledge of the natural course of disease. The use of infinitesimal doses has also led to much care being bestowed by those who use them upon diet and regimen. When a physician administered a large dose of tartar emetic or of salts and senna, he knew that his remedies would produce vomiting or purgation respectively with considerable certainty, whatever the diet or regimen of the patient might be; but the case was quite different with infinitesimal doses. If a patient was being treated with carbo vegetabilis in the thirtieth dilution, the utmost care was necessary in regard to his diet, for if he happened to eat a single piece of burned toast at breakfast, he would consume at the one meal as much vegetable charcoal as would, when properly diluted, have served him for medicine during the remainder of his natural life.

Moreover, the homoeopathic practice of giving only one drug has tended greatly to diminish the practice of polypharmacy, and the tinctures, powders, and globules they employ show us a good example in regard to the administration of remedies in an agreeable form. But, although this mode of practice may be employed by homoeopaths, it is not homoeopathic. We are not homoeopaths because we use a single drug at a time and give half an ounce of infusion of digitalis to a patient suffering from heart-disease without thinking it necessary to mix it with broom, squill, or spirit of nitrous ether. Nor are we homoeopaths because we use l-50th of a grain of digitalin instead of the infusion of digitalis. Nor are we homoeopaths even if we get a manufacturing chemist to make up the digitalin into a globule with a quarter of a grain of sugar of milk instead of with five grains of extract of liquorice. Nor do we become homoeopaths merely because we may employ a small dose instead of a large one, and begin with ten drops of the infusion of digitalis instead of half an ounce.

It is not the use of a single drug at a time, of a small dose, of a globule, nor even, as we have already seen, of a drug which may produce symptoms similar to those of the disease, that constitutes homoeopathy. The essence of homoeopathy, as established by Hahnemann, lies in the infinitesimal dose and the universal application of the rule similia similibus curantur. But the infinitesimal doses are so absurd that I believe they have been discarded by many homoeopaths. To such men all that remains of homoeopathy is the universality of the rule similia similibus curantur, and the only difference between them and rational practitioners lies in the fact that the latter regard the rule as only of partial application. At first sight this difference may seem to be only slight, but it is not so in reality; for while the rational practitioner, refusing to be bound by any 'pathy,' whether it be allopathy, antipathy, or homoeopathy, seeks to trace each symptom back to the pathological change which caused it, and, by a knowledge of the action of drugs on each tissue and organ of the body, to counteract these pathological changes, the homoeopath professes to be in possession of a rule which will enable him to select the proper remedy in each case by a consideration of the symptoms, without reference to the pathological condition. He may thus dispense with anatomy, physiology, pathology, and pharmacology. All that is necessary is a list of morbid symptoms on the one hand, and a list of the symptoms produced in healthy men by various drugs on the other.

It is the falsity of the claim which homoeopathy makes to be in possession, if not of the universal panacea, at least of the only true rule of practice, that makes homoeopathy a system of quackery; yet this arrogant claim constitutes the essence of the system, and the man who, leaving Hahnemann and going back to Hippocrates, regards the rule similia similibus curantur as only of partial and not of universal application, has no longer any right to call himself a homoeopath.

Yet we hear some leading homoeopaths say, 'We do not claim any exclusiveness for our method,'1 and then complain that they are excommunicated by the medical profession. If they have renounced the errors of Hahnemann's system, they ought not to retain its name, but frankly acknowledge their error and return to rational medicine, of which Hippocrates is regarded as the father. As a medical man is bound to do his utmost for the good of his patient, it is obvious that, although he may employ baths or packs as a mode of treatment, he cannot, without becoming untrue to his profession, throw aside all other means of treatment and become a hydropath; nor can he consult on equal terms with those who, either through ignorance or wilful blindness, deny the use of other means of cure and limit themselves to the application of water. What is true of hydropathy is true of homoeopathy. I dislike controversy extremely, and should not have taken up so much of the preface with controversial matter had I not been forced to defend myself by the attacks which certain homoeopaths have made upon me.

I may now turn to the pleasanter task of acknowledging my indebtedness to many friends who have helped me in the preparation of this edition. In addition to some of those who helped me with former editions, I have to thank Dr. Hughlings Jackson for assistance in the construction of the diagram which illustrates his views of the nervous system; Mr. W. H. Jessop and Mr. Tweedy for much aid and many suggestions in revising the section on diseases of the eye; and I am especially grateful to my friend, Dr. Thin, who has greatly added to the value of the book by writing an account of the uses of various remedies in skin diseases. I am indebted to Mr. Whitehead, Dr. Halliburton, and especially to Dr. Sidney Martin, for their assistance in passing this edition through the press. To Dr. Martin I am also indebted for many valuable suggestions, and for such an amount of help that, but for him, the preparation of this edition would certainly have been delayed for many months.

1 Preface by Eichard Hughes to The Medical Treatment of our Time. London: Unwin Brothers, Ludgate Hill.

March, 1887.

T. Lauder Brunton